England has been fudging the issue by claiming there is no evidence base for minimum safe-staffing ratios. How can that be true in England but not in Wales?

NHS England’s claim is really just code for “we can’t afford it and even if we could, we haven’t trained enough nurses to staff wards safely”.

After the Royal College of Nursing found that chief nursing officer for Wales Jean White’s recommended average nurse-patient ratios – 1:7 in hospitals during the day and 1:11 during night shifts – were going largely unmet, the decision was taken to mandate what had previously just been guidance.

Of course, the Act also compels Wales to get its house in order for workforce planning. Minimum numbers require a good supply of registered nurses and therefore more training places. In the meantime, NHS Wales accepts that agency use will increase.

But if nurses will be working with the right number of colleagues, and feeling supported and able to do their jobs to the appropriate standard, this is likely to boost morale, reduce burn-out and increase retention.

While the legislation will initially be applied only in adult acute and surgical wards in NHS hospitals, it is likely to be extended further.

So why is there support for this in Wales but no appetite in England? While England strangles trusts with agency caps, throws the supply of students into chaos with a poorly managed plan to reform education funding and scrambles to find a new role that is, I fear, very likely to replace many registered nurses (we have too few RNs, which is why the nursing associate role is being created), Wales has mandated safe-staffing RN ratios.

If the evidence for safe staffing exists in Wales, then surely it is the same across the UK?

Or are we to believe that care is only affected by the number of registered nurses providing it once you cross the Severn Bridge from England?

I wonder whether healthcare providers are so focused on safety that they have forgotten about quality and the patient experience. Or have they simply been forced to just deprioritse those aspects of care?

There’s a tendency when we hear negative criticism about our performance to dismiss it – because we are busy and overworked, so the mistake we have made is acceptable, because the complainant doesn’t understand our context, or because it’s coming from someone “who always moans”.

Urgent action is needed to tackle mounting pressures on the NHS in Scotland including “major workforce challenges”, with health boards struggling to recruit and retain nurses and other staff, the country’s chief auditor has warned.

no mention of Scotland....or Ireland....they don't have minimum numbers in Scotland either. I think we all know the reason why! Because there would never be enough staff to do this and the government like to cover up nursing shortages but if they brought this in it would then be exposed. It has been long overdue.

In care homes staffing levels are even worse. In one I was the only nurse with 71 residents, 17 were classed as nursing. However those 17 were violent EMI residents.
Incidents happen and one did, I ended up before our adversaries the NMC. Taking it to an appeal Judge Gosnell said "The unsafe working environment and the dangerous staffing made the staff position intolerable"
Carehome owners should take that as a warning for future cases. Dangerous staffing will not be tolerated by the appeal courts even if the NMC will not accept it as a 'strong mitigating circumstance'

Have your say

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.

In Opinion

Unlimited access to Nursing Times...

...gives you the confidence to be the best nurse you can be. Our online learning units, clinical practice articles, news and opinion stories, helps you increase your skills and knowledge and improves your practice.